Scottie Stinson, a coal miner of 16 years, works to secure the roof with bolts in a coal mine roughly 40-inches-high, Tuesday, Oct. 6, 2015, in Welch, W.Va. The one main source for decent-paying work, the brutal life of coal, seems to be drying up for good. The thick, easy, cheap coal is gone, global competition is fierce, and clean air and water regulations are increasing costs and cutting into demand. But this crisis and the realization that there won’t be another coal boom in these parts is leading to a growing understanding that new approaches are needed to help Central Appalachia emerge from decades of deep poverty, under-education and poor health. (AP Photo/David Goldman)